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NPI Code Detail

MEDICARE: LAURA RONGOMAS RPH

MEDICARE: LAURA RONGOMAS RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist14739NV

General Provider Information

NPI Number : 1821371998
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA RONGOMAS RPH
Provider Business Mailing Address
First Line : 4824 WHISPER LAKE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-2607
Country : US
Telephone Number : 615-423-1955
Fax Number :
Provider Business Practice Location Address
First Line : 2280 N LAS VEGAS BLVD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-5803
Country : US
Telephone Number : 702-649-1415
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2011
Last Update Date : 09/24/2011

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Directions to “ LAURA RONGOMAS RPH” Practice Location

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